Pharmacogenomic (PGx) testing for major depressive disorder (MDD) can reduce healthcare spending and improve patient outcomes. However, concerns about health equity, data privacy, and secondary usage of data require deliberation. We sought recommendations from members of the general public for policymakers' consideration.

A four-day public deliberation was held in Vancouver, British Columbia (BC), from November-December 2024. Invitations were mailed to 15,000 randomly-selected households in BC. Participant selection maximized socio-demographic diversity. Participants received an information booklet and heard from expert speakers before discussing whether and how PGx testing for MDD should be implemented. Participants then generated and voted on recommendation statements. Finally, participants engaged with policy-/decision-maker panelists. Sessions were audio recorded and transcribed.

Thirty participants generated 15 recommendations. Publicly funding PGx testing for MDD was supported under certain conditions. Participants unanimously called for strict test reporting standards, in line with evidence-based prescribing guidelines. Healthcare professional (HCP) education was seen as necessary, with ongoing access to PGx experts. To enhance accessibility and acceptability, the group suggested re-naming this "PGx testing (medication compatibility testing)" and conducting a targeted awareness/education campaign. However, participants wanted additional efficacy data collected across diverse ancestry groups to ensure PGx testing benefited everyone. While they agreed test results could be shared between HCPs, they wanted further public engagement on using PGx results in research without consent.

Knowledge gained throughout the event appeared to reduce concerns around data privacy, highlighting the importance of pre-implementation education and awareness. These recommendations provide guidance to policymakers considering PGx implementation.

Folic acid (FA) is essential for fetal development, while the benefits and optimal dose in pregnant women with epilepsy (PWWE) remain unclear. This study explores effects of FA supplementation, dose, and initiation time on offspring outcomes in PWWE.

This multi-center cohort recruited PWWE from 58 hospitals in China. Anti-seizure medication (ASM) and FA exposures were categorized by first-trimester use. The primary outcome was a composite of preterm birth, low birth weight (LBW), major congenital anomalies (MCAs), fetal death, and neurodevelopmental delay. Logistic regression models assessed the associations between FA exposure, dose, initiation time, and adverse outcomes, adjusting for demographics and epilepsy characteristics, with stratification by maternal ASM use. Dose-response relationships were analyzed using restricted cubic splines.

Among 1013 women with 1209 pregnancies, 952 received FA. In ASM-exposed pregnancies, FA supplementation was associated with lower risks of composite adverse offspring outcomes (adjusted odds ratio [aOR] .59, 95% confidence interval [CI] .387-.911) and fetal death (aOR .127, 95% CI .054-.296), whereas no significant differences were observed between preconception and first-trimester initiation. Compared to no supplement, supplementation with .4 mg/day protected against fetal death (aOR .185, 95% CI .078-.428); doses exceeding .4 mg/day further reduced risk of composite adverse outcomes (aOR .343, 95% CI .162-.675), and doses above 1 mg additionally showed trends toward decreased preterm birth in ASM-exposed pregnancies (aOR .338, 95% CI .104-.943). Compared with .4 mg supplementation, doses above 1 mg/day were associated with a lower risk of LBW (aOR .208, 95% CI .05-.58).

FA supplementation was associated with lower risks of composite adverse offspring outcomes in ASM-exposed pregnancies, specifically at doses exceeding .4 mg. No such associations were observed in pregnancies not exposed to ASMs. However, the optimal upper limit of high-dose FA supplementation requires further investigation.

Individuals with mental disorders have an increased risk for metabolic disturbances, inflammation and nutrient deficiencies. Nevertheless, nutritional aspects have so far received little attention in psychiatric care. Nutritional psychiatry and nutritional psychosomatics (NP) combine psychiatry with nutritional and lifestyle medicine to systematically integrate the interaction of these domains into the diagnostics and therapy.

Illustration of specialized structures and description of three outpatient clinics in the DACH region (Germany, Austria and Switzerland).

Overview of scientific foundations, international trends and guidelines, along with a description of the clinics based on the locations.

The outpatient clinics represent complementary approaches: Graz focuses on nutrition and mental health, the gut-brain axis and integrative therapy; Berlin emphasizes micronutrient diagnostics and functional medicine; Zurich adopts an interdisciplinary, behaviorally and pharmacologically oriented approach. Together, they highlight the need for specialized, multiprofessional structures and scientific evaluation.

The discipline of NP opens up new avenues for prevention and personalized therapy. To meet the high demand and address existing challenges, greater capacity, interdisciplinary networks, health services research and integration into regional healthcare systems are needed. Close alignment of research and clinical practice is essential to sustainably establish evidence-based care concepts and teaching approaches in psychiatry.

Intelligence testing is an important tool for clinicians to help in diagnosis and treatment planning for children with neurodevelopmental disabilities. Although interpreting IQ profiles is a common clinical practice, there are concerns regarding the validity and reliability of such scores. Previous research has shown relatively stable global measures of IQ, but less stable scores within index or subtest score. More research is needed to better understand the long-term stability of IQ scores within autistic and other neurodevelopmental populations who may have more instability in their scores over time.

We tested the long-term stability of IQ scores using the same test over time (Stanford-Binet, Fifth Edition; SB-5) in a large clinical sample of 650 youth with autism (n = 236) or other neurodevelopmental disabilities (n = 414), over a period of 4 months to 11 years. In addition to IQ scores, we also tested consistency of scatter scores, overall profiles, and strengths and weaknesses using linear mixed effects models.

Results indicated overall consistency of FSIQ scores (ICC = 0.86), slightly less stability for VIQ and NVIQ, and low stability for abbreviated IQ as well as index and subtest scores. The consistency of cognitive profiles, scatter scores, and strengths and weaknesses was poor. Younger age was the best predictor of higher FSIQ instability.

Long-term stability of IQ in neurodevelopmental disabilities appears similar to results from other studies with different clinical and nonclinical groups. Implications and recommendations are discussed.

Our study identifies sociodemographic, clinical, and behavioral factors associated with serious psychological distress (SPD) among US adult cancer survivors, highlighting actionable targets for mental health interventions in survivorship care.

We analyzed 2024 National Health Interview Survey data from adults aged ≥ 18 years with a self-reported history of cancer and complete Kessler-6 and covariate data (unweighted n = 3,680; weighted ~ 22.2 million). SPD was defined as a Kessler-6 score ≥ 13. Weighted prevalence and multivariable logistic regression identified independent correlates.

The weighted prevalence of SPD was 3.7% (95% CI, 3.0%-4.5%). SPD was higher among adults aged 18-44 years (10.2% [5.5%-14.9%]) versus ≥ 65 years (2.4% [1.7%-3.1%]), women (4.8% [3.5%-6.0%]) versus men (2.6% [1.7%-3.6%]), and those with Medicaid (14.4% [7.5%-21.2%]) or no insurance (14.1% [3.6%-24.5%]). SPD was also elevated among survivors with frequent loneliness (11.7% [8.9%-14.4%]), low social support (10.7% [7.8%-13.7%]), life dissatisfaction (24.0% [16.5%-31.5%]), and functional limitations (5.5% [4.3%-6.7%]). In multivariable analyses, frequent loneliness (aOR 5.46 [2.39-12.47]), low social support (2.92 [1.40-6.08]), and life dissatisfaction (3.92 [1.64-9.46]) were independently associated with SPD; odds were lower among non-Hispanic Black adults (0.28 [0.08-1.00]). Sensitivity analyses excluding psychosocial variables strengthened associations for younger age and Non-Hispanic Black race/ethnicity.

Serious psychological distress affected a clinically important minority of US cancer survivors and was strongly associated with psychosocial factors, including loneliness, social support, and life satisfaction.

Integrating psychosocial assessment and targeted support into survivorship care may reduce distress and improve overall well-being.

Premature ovarian insufficiency (POI) is a harmful disease that leads to decreased fertility and osteoporosis and an increased risk of cardiovascular disease. POI seriously affects women's physical and mental health. Currently, the incidence of POI is rising; however, the etiology of most cases remains unclear, and these cases are referred to as idiopathic POI. Understanding the risk factors for idiopathic POI is beneficial for preventing and recognizing POI early on, as well as for improving treatment outcomes. This paper describes the etiology and pathogenesis of idiopathic POI from five perspectives: genetic and familial factors; environmental factors (including endocrine-disrupting chemicals, persistent organic pollutants, and heavy metals); gut microbial disorders; lifestyle factors (including smoking, diet, physical activity, and pathological sleep); and psychological and social factors. Furthermore, this review discusses the interactions among these risk factors and provides clinical prevention recommendations. This study aims to improve clinical diagnosis and treatment of idiopathic POI and women's health.

Cannabis Use Disorder (CUD) affects ~ 50 million individuals worldwide and is associated with alterations in brain reward pathways. Mindfulness-based interventions (MBIs) show promise in reducing substance use and aberrant brain function in substance use disorders (SUD), but the effects on CUD or brain reward function have not been investigated. To examine whether a 2-week MBI vs. active control (i.e., closely matched relaxation) and passive control (i.e., no intervention) affected brain reward function in CUD using the Monetary Incentive Delay fMRI task, 49 individuals with moderate-to-severe CUD were randomised to: a 2-week MBI (n = 18), active control condition (n = 15), or passive control condition (n = 16), and assessed before and after the intervention. The effect of intervention-by-time was analysed using an exploratory whole-brain approach and a priori regions-of-interest approach (ROIs; ventral striatum, dorsal caudate, putamen, insula, cingulate, and orbitofrontal cortices). Whole-brain results revealed significant intervention-by-time effects. Post-MBI, there was: decreased cerebellum activity while anticipating monetary cues, increased parietal activity while receiving monetary wins, and decreased fusiform/superior frontal gyri (SFG) activity while receiving monetary wins. Post-relaxation, activity increased in several regions (i.e., hippocampus, insula, parietal cortex, fusiform, and SFG) during the receipt of monetary wins. Post-no intervention, activity increased in the cerebellum while anticipating monetary cues, and decreased in other areas (i.e., parietal cortex, hippocampus, and insula) while receiving monetary wins. There were no significant intervention-by-time effects using the ROI approach. Overall, MBI, matched relaxation, and no intervention may share changes in partially overlapping brain regions in distinct directions.

Suicide is a serious public health crisis, and lesbian, gay, bisexual, and transgender (LGBT) adults are at particularly high risk. The present study examined risk factors for mortality by suicide and other causes in LGBT versus non-LGBT middle-aged and older adult veterans who used Veterans Affairs health care services between 2009 and 2019 (n = 834,774). We hypothesized that LGBT veterans (n = 167,676) would be at increased risk of premature mortality from suicide, overdose, and other causes of death compared with non-LGBT veterans (n = 667,774), due to minority stress as measured by proxy risk factors of health and social determinants of health. In bivariate models, LGBT veterans had significantly higher rates of death by suicide and overdose compared with non-LGBT veterans. After controlling for proxy risk factors of minority stress in multivariate analyses, the risk associated with LGBT status was nonsignificant. Sociodemographic variables (e.g., race/ethnicity, age), mental health diagnoses, substance use, and other risk factors contributed significantly to differences in risk. Findings highlight the critical importance of interventions (e.g., U.S. Department of Veterans Affairs Whole Health) for LGBT veterans to manage multiple health risk factors that contribute to mortality risk. Suicide prevention is crucial, especially for middle-aged, older adult, and LGBT veterans. Initiating targeted suicide prevention earlier in life may prevent suicide deaths. Findings also implicate subgroups of veterans who may particularly benefit from systematic improvements to health care delivery. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

This column presents a first draft of the Psychotherapy Selection Algorithm (PSA 1.0), developed by a workgroup of the American Psychoanalytic Association. The goal of PSA 1.0 is to address bias in psychotherapy selection and to reexamine treatment selection so that it is based on evidence that includes the effectiveness and efficacy of psychodynamic therapy and psychoanalysis.

Synthetic cannabinoids (SCs) are the fastest-growing class of novel psychoactive substances in Brazil, yet epidemiological data on their prevalence and correlates remain limited. This study examined differences in sociodemographic, treatment, and clinical characteristics between individuals in substance use treatment who reported SCs use and those who did not, and identified factors associated with SCs use frequency.

The study extracted data from electronic health records of all individuals who sought treatment for their alcohol and/or drug use in "HUB de Cuidados em Crack e Outras Drogas", Sao Paulo, Brazil, between June 2024 and July 2025 (N = 6,660).

A total of 1943 service users (29.17%) self-reported using SCs in the past 12 months. Of these, 28.9% initiated use before age 21, 51.7% reported polysubstance use (cocaine, crack-cocaine, and cannabis) before initiating SCs use, and 63.4% reported daily use. Compared with non-users, SC users were more likely to be younger, to have attended another treatment service in the past 12 months, and to have frequented open drug scenes (ODS). They also reported greater use of cocaine, crack-cocaine, cannabis, solvents, and methamphetamines, higher rates of polydrug use, more severe cocaine/crack addiction scores, and more frequent high or severe psychotic symptoms. Similar factors were associated with the frequency of SCs use.

The findings reveal a mixed profile of SCs users comprising individuals from ODS and younger users from other areas. It highlights the need for adaptive public health policies, enhanced surveillance, and tailored treatment approaches to address the evolving complexity of Brazil's drug landscape.